Getting to the root of anesthesia-free veterinary dental care

Despite the fact that the American Animal Hospital Association (AAHA) calls pet dentistry without anesthesia "unacceptable and below the standard of care" and the American Veterinary Dental College (AVDC) has issued a position statement warning against its use, the practice is gaining acceptance in the veterinary community. The result? A wide range of opinions and some strenuous objections.

For one thing, as of Nov. 1, AAHA-accredited practices that don't comply with this standard won't pass their evaluation. For another, the AVDC objects altogether to the term "anesthesia-free dentistry," preferring to call it "nonprofessional dental scaling"—the word "dentistry" is a misnomer, they say. But other doctors say some level of care without anesthesia is better than nothing, and it's at least a step in the right direction. Before making your final call, read on to see what your colleagues have to say about this issue.

It's better than nothing—isn't it?

"I have clients who are completely unwilling to put their pet under anesthesia either from fear or due to a severe cardiovascular disease that makes it higher-risk," says Stephanie Sur, DVM, associate at The Whole Pet Vet Hospital and Wellness Center in Los Gatos, Calif. "For those patients, it provides a way to give some oral care, which in my opinion is better than no oral healthcare at all."

Sur has worked with Pet Dental Services, a fast-growing company that provides pet owners with an anesthesia-free option. The company works with a network of about 300 veterinary practices (it started in 2006 in California with about 10), offering its services within veterinary clinics. Sur has personally worked with anesthesia-free dentistry since 2003 and for two years at her current practice. She also has recently co-authored a study on the effectiveness of non-anesthetic dentistry (see "Study on professional outpatient preventative dentistry," http://ivcjournal.com/research-studies/).

"My clients have responded very well to this option," she says. "Some sigh with relief that they don't have to spend hundreds of dollars for an anesthetic procedure. Others are relieved because we have removed the fear of anesthesia."

Sur has had patients come from other area clinics just for this service, and her waiting list is long. She says clients trust that she won't recommend a more expensive anesthetic procedure when she deems an anesthesia-free option appropriate for that pet.

And that's another reason some doctors support this growing trend: It costs less, which means more clients are willing to spring for it. That increases compliance and ancillary services, proponents say—plus, many clients do opt for anesthesia-required procedures if their pets' needs are beyond the scope of what an anesthesia-free cleaning can address.

For George Zafir, DVM, an independent general practitioner in Lake Worth, Fla., non-anesthetic dental cleanings have provided a whole new revenue stream. "Here we have an independent third party that charts the pet's mouth and discusses issues they find with the client, in detail," he says. "This alerts pet owners to potential problems and gives us a chance to promote oral care products."

This so-called halo effect has been good for Zafir's business. For the last seven years, he has seen 12 to 14 patients a month for non-anesthetic dental cleanings at $200 each. He says many of those clients wouldn't otherwise pay for a dental with anesthesia. "We can do a non-anesthetic at less risk or cost until we are to a point where that is not the appropriate way to deal with that mouth," he says. "I offer it as an adjunct service, an alternative that gives us a competitive edge over other veterinarians. It's not my first option, but it's a good option."